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Breast Carcinomas

This document summarizes different types of breast carcinomas: - Lobular carcinoma in situ is not visible but often develops into invasive carcinoma and expresses estrogen and progesterone receptors. - Invasive ductal carcinoma, no special type accounts for 80% of cases and presents as hard, irregular masses that are often in the left breast. - Invasive lobular carcinoma accounts for 10% of cases and presents as poorly defined, multicentric tumors with single-file cell patterns. - Other less common types include tubular carcinoma, medullary carcinoma, mucinous carcinoma, and inflammatory carcinoma. Molecular subtypes include luminal A, luminal B, HER2-positive, basal, and normal-like types.

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Girkati Shivani
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27 views19 pages

Breast Carcinomas

This document summarizes different types of breast carcinomas: - Lobular carcinoma in situ is not visible but often develops into invasive carcinoma and expresses estrogen and progesterone receptors. - Invasive ductal carcinoma, no special type accounts for 80% of cases and presents as hard, irregular masses that are often in the left breast. - Invasive lobular carcinoma accounts for 10% of cases and presents as poorly defined, multicentric tumors with single-file cell patterns. - Other less common types include tubular carcinoma, medullary carcinoma, mucinous carcinoma, and inflammatory carcinoma. Molecular subtypes include luminal A, luminal B, HER2-positive, basal, and normal-like types.

Uploaded by

Girkati Shivani
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© © All Rights Reserved
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Breast Breast carcinomas

G .Laxmi Shivani
Lobular carcinoma in situ(LCIS)
➢ LCIS is not a palpable or
grossly visible tumour.
➢ 30% of the women with LCIS
eventually develop invasive
carcinoma.
➢ LCIS almost always
expresses ER & PR.
➢ Terminal ducts & ductile said
are seen
➢ Acini are recognised by
lobules
Invasive Breast carcinoma
Morphological classification -
🔻Invasive carcinoma of no special type-Nst.
🔻 Invasive lobular carcinoma.
🔻 Tubular carcinoma.
🔻 Mucinous carcinoma.
🔻 Cribriform carcinoma.
Invasive duct carcinoma,no special type
➢ 80% cases of the breast
cancer.
➢ Hard consistency due to
dense collagenous stroma.
➢ More frequently in the left
breast & often in the upper
quadrant.
➢ Retraction of the nipple.
Grossly
➔ Irregular.
➔ 1-5 cm in diameter.
➔ Hard cartilage like mass that cuts with
a grating sound.
➔ Grey-white to yellowish with chalky
streaks.
➔ Extends into surrounding fat.

Histologically
➔ Anaplastic tumour cells forming solid nests
, cords , poorly formed glandular structures
and some intraductal foci.
➔ Invasion into peri vascular & peri neural
spaces.
Molecular classification of NST

🔺 Luminal A type

🔺 Luminal B type

🔺 Normal breast like type

🔺 Basal type

🔺. HER2 positive
Luminal A type
● 40-50% of NST.
● ER positive & HER2/neu negative.

Luminal B type
● 15-20% of NST cancer.

● triple positive cancers.


Normal breast like type. Basal type.
● 6-10%. ● 13-25%
● ER positive & HER2/neu ● absence of ER,PR & HER/neu
negative with gene i.e triple negative.
expression pattern similar
to normal tissue.
HER2 positive
● 7-12%
● ER negative but HER2/neu positive
Invasive lobular carcinoma
➢ 10% of all breast cancer.
➢ More frequently bilateral
➢ Or within the same breast may
have multicentric origin.

Grossly
➔ Poorly defined area
➔ Remains undetected by
inspection as well as palpation.
Histologically
➔ Pattern:- single (Indian file) linear
arrangement of stroma.
➔ Infiltrating cells are concentrically
arranged around ducts in target
pattern.
➔ Tumour cytology :-individual cell
resembles cells of in situ lobular
carcinoma.
➔ Round & regular with little
pleomorphism and infrequent mitosis.
➔ Shows signet ring cells with mucin in
cytoplasm.
Tubular carcinoma
➢ 6% cases of the cancer.
➢ Tumours are small ~ 1 cm
diameter.
➢ Ill-defined & gritty nodules.
Histologically
➔ Pattern:- tubules having
angulated shape.
➔ Tumour cell:- regular and
form a single layer in well
defined tubules.
➔ Stroma:- distributed in dense
fibrous stroma.
Medullary carcinoma
➢ 2% of the cancers
➢ Soft ,fleshy & well circumscribed mass
➢ Also named “encephaloid carcinoma”.
➢ Cut section shows haemorrhages and
necrosis.

Histologically
➔ Tumour cells:-sheets of large, pleomorphic
tumour cells with abundant cytoplasm
➔ Large vesicular nuclei.
➔ Blizzard and atypical mitosis are diffusely spread
in the stroma.
➔ Stroma:-loose connective tissue is scanty.
➔ Lymphoplasmacytic infiltrate in & around the
tumour.
Mucinous carcinoma
➢ Mucinous or colloid carcinoma is seen in 2% of the
cases.
➢ In older women.
➢ It is slow growing tumour.

Grossly:-
➔ Soft & gelatinous mass with well
demarcated borders.
Histologically:-
➔ Large amount of extracellular epithelium and acini filled with
mucin.
➔ Cuboidal to tall columnar tumour cells
➔ Some show mucus vacuoles are seen floating in large lakes of
mucin.
Other types of invasive breast carcinoma
Papillary carcinoma:-
➔ Micropapillary accounts for less than 1% of all invasive
carcinoma
➔ Occur mostly in 7th decade
➔ Lymph node metastasis is very common and prognosis
is poor.
Metaplastic carcinoma
➢ Rare tumour - less than 1% of all cases.
➢ Types - matrix producing carcinoma & squamous
cell carcinoma.
➢ They are triple negative but often express
myoepithelial proteins.
Inflammatory carcinoma
➔ 1.5 -3% of all cancers.
➔ Clinical features : erythema , peau d’orange , skin
thickening
➔ Redness , oedema , tenderness and rapid enlargement.

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